People/Patients you don't like

[Aellyssa]

this really comes out of the care for/ care about thread.

i lecture in nursing, and one of the tenets i teach is, of course, professionalism and how we should all be able to nurse all people. but then i add a caveat - if there are some people whom you really detest and whom you have difficulty nursing, then you need to be aware of this and do something about it ie examine why you feel this way & try to change it or get someone else to care for them. i can think of some people who i would have extreme difficulty caring for because of their beliefs, political leanings &/or criminal activity. now i haven't met these people and my first act would be to get to know them first and try to nurse the person not the belief, ideology or criminal act. but there are some people whom i genuinely dislike despite all of this. as a feminist i have had difficulty caring for people who have raped, and abused women, as a family maiden aunt, i have had difficulty with child abusers and paedophiles.

we are all human, with all that being human entails. we cannot like all people. this means that there will be people whom we have difficulty nursing. i also know the rhetoric about professionalism. professionalism promotes an ability to look after all people, regardless of their race, creed, religion, ideology or sexual preference. but, believe me patients are always aware of when the nurse likes or dislikes them - it shows in a myriad of ways that professionalism doesn't hide.

please don't tell me that this doesn't happen in nursing. i have seen it - how "drug overdoses" are treated in er, the "drug addict", the "alcoholic", the woman having an elective abortion, the ethnic minorities, the gays etc. i am trying to be brutally honest here and confront some of the hidden demons in nursing.

in australia it is often our indigenous people who are discriminated against, especially if they are from rural & remote settlements. it happens. i have difficulty nursing some aboriginal people, not because of their race, but because i don't know enough about their cultural mores and i have a collective guilt about how we have treated them especially with the stolen generation.

so who have you had difficulty nursing because you disliked them and what did you do about it?

aellyssa

[Indy, LPN, LVN]

I haven't seen anyone yet that I could not care for. However, I'm sure that may change. I know of a person whom, in reality, I'd give away in a heartbeat- that would be my ex-stepfather (mom divorced him, too little too late). That's one person I couldn't do the first thing for, in any manner, professionally or not.

So, I can imagine that it's going to be an issue for me to be confronted with bad parents and people who engage in domestic violence. I can't tell you any answers at the moment, because all of the behaviors that I would use to currently deal with such stress, aren't helpful and/or professional. It's an area of life that will probably require counseling and a lot of work on my part, to deal with.

[Nurse Ratched, RN]

There was a situation where a person responsible for a death (person was driving drunk) made a stop on our unit after theaccident but before court. I was not assigned to care for this pt but had I been, I would have respectfully asked another person to take the assignment. That's the only time I've felt strongly about not caring for a particular pt.

I think it's EXTREMELY important to recognize our own prejudices and be brutally honest with ourselves if we can't get by them enough to provide non-judgemental care to someone.

[RoxanRN]

so who have you had difficulty nursing because you disliked them and what did you do about it?

we recently had a gentleman in our unit who was the cause of a high-speed crash (porsch going 120+ mph on a freeway marked 60mph) involving 3 cars (his included). the cars burned - he was ejected. in one car, a man lost his wife in the fire and he is currently in our burn unit along with another man from a 2nd car. the "hitter's" serum drug screen came back positive for cocaine and i think he was also drunk. after almost 40 days in an icu, he was finally moved to the floor. he has gone from totally unresponsive to communicating appropriately (mostly). he suffered fractured ribs requiring chest tubes, cervical fractures (no deficits), chi, and a radial/ulnar fracture requiring orif. he has a trach (breathing on his own now) and peg. his 'victims' are still in the burn unit and will be for a long while.

my problem is i couldn't find the compassion to care for him. i could care for him professionally (which i did several times) to the best of my ability, but the compassion was severely lacking. this really bugged me. i've talked to a few other nurses on my unit and the lack of compassion for this patient seems to be a common theme. if he is ever deemed competent for trial (very well may not happen), he will probably face, among others, vehicular homicide, driving while impaired, demonstration of speed, etc.

as i sit here to type this, i start fuming all over again - not because of what he did, though that's there too - but because of the reactions he caused in me. yes, i've cared patients who have been the source of other's deaths, but only in the pre-hospital setting (i'm an 11 year old paramedic). i never had time to dwell on the circumstances. i'm very upset and disturbed at myself for having this lack of compassion. it's the first time i've ever felt this way. i've been told i've had as much compassion as job had patience.

i'm sure i will eventually come to terms with this. i hope it's a long time before i have to face it again.

roxan

[VivaLasViejas, ASN, RN]

I haven't yet met the patient I couldn't care for at all, but I've had a few I didn't have any use for, that's for sure! One of the most memorable was the homeless child molester who set fire to our church 15 years ago, after he'd been served a hot meal and given a bed for the night. Nice way to repay the charity he'd received........well anyway, he spent a number of years in prison, then came back here and lived in a tent on the county jail's front lawn because he was so notorious that no one would rent to him. He got pneumonia---in no small part due to exposure---and wound up in our ICU for a week.

The night he was moved to our floor, I was the 'lucky' nurse who took care of him. The funny thing was, it was hard to reconcile this frail old man with the monster whose picture had been all over the front page of the newspapers in 1989 when our historic, 98-year-old church burned to the ground. Shrunken and weak, with a soft voice and polite manner, he was only a sick elderly man in need of nursing care.......and he got it. I even found myself feeling just a little bit sorry for him---not that his crimes weren't horrendous, but he'd served his entire sentence, paid his debt to society, and now couldn't even rent a crummy apartment in Felony Flats (what we call a certain area of town) because of his history. And now he was seriously ill.......it was just kind of sad.

But for me, the absolute worst was the white-supremacist 'skinhead' who wouldn't let the CNA, who is Filipina, even set foot in his room.......he'd had an emergency appendectomy, and assessing him with all the Nazi swastikas and anti-everybody sentiments tattooed all over his body just made my skin crawl. He had a horrible attitude.....he was OK only with staff members he was sure were WASPs. Well, I may look like one, but I'm not, and I don't suffer racists easily......just touching him made me feel dirty, all I wanted to do when I got off my shift that day was to go home and take a bath. :stone

[leslie :-D]

i had one pt who was a convicted pedophile and had served his time.

being the only hospice nurse at the facility, i had no choice.

but for personal as well as the obvious moral reasons, it repulsed me to have to take him.

yes, i was professional. that's it. minimal conversation.

he asked me if i thought he was going to hell when he died.

i asked him "do you think you should go to hell?" and he nodded his head and started crying with evident fear.

my only response to him when he cried was, "my God is a loving and compassionate God, but yet Mr. so and so, I'm glad there are no children in hell."

but i ensured he got all his pain meds and treated him as i did any other pt. in terms of 'tasks'. i even got him a priest.

that was the only hospice case i ever wanted to run from.

but he died w/o physical pain, was kept cleaned, repositioned, check on several times re: comfort levels, needs, etc.

it still made me sick to my stomach though.

[stidget99]

I had to nurse an ex LPN who was convicted of killing several elderly pts w/ potassium. It was very hard to not go into his room and say "ok, I have your potass...no I mean your morph...er, potass...no! no! I really do have your morphine here!" I honestly believe that I would have been capable of doing this if it was just the two of us in the room. Good thing he had guards on him. Did I have any compassion for him what-so-ever? Absolutely not. Did I nurse him? Do everything that I needed to do for him? Yes to both.